One might think of this abusive practice as anachronistic, a vile remnant of the 1950s, but it's still very much alive.

A reader who commented on Ms. Brown's piece (#2, MKM) noted that as a former hospital clerical worker, he/she had probably received more abuse from nurses than from doctors. That's the way the chain works: abuse rolls downhill. Almost without exception, child abusers had been abused themselves as children.

I doubt docs will stop abusing anyone until their own abuse stops. From my own training in the 1960s, I recall that freshman medical students suffered a status somewhere below mollusks. Sophomores and juniors were noticed, but mainly as nuisances, like rodents. Seniors found that the summit they’d attained was at the same time dirt on the shoes of interns, who in turn were nameless drudges to resident physicians. And so on up to the pyramid’s apex, the Chair of the Department, who glowed with success while fretting about the associate professors clawing at his or her ankles. From what I hear, medical training is a little more humane now, but the atmosphere remains unquestionably vertical.

Still, re-education is possible. My guess is that the docs who disparage nurses in front of patients (along with other abuses) do it unthinkingly, almost as a matter of course. They have no idea they're damaging people, and if they did, they might behave differently. A nurse or other colleague can take them aside, as a nurse once did with me, and advise, "Doctor, if you keep going where you're going, you're going to get where you're headed."

Alas, I feel that the extremely harsh criticism in all the Well Blog comments amounts to insult to injury to nurse Brown. The comments to her lovely, heartfelt articles tend more and more to cries of "doctor bashing"--and Zack in Chicago (#49) claimed he was canceling his subscription to the Times because of it!

Is this not the problem Ms. Brown was trying to address--doctors who abuse their chain of command and have zero tolerance towards anyone who fights back and stands up for themselves--then, as we see throughout our political sphere, blames the victim by claiming such self defense is "doctor-bashing," while also trying to deflect attention by pointing out how abusive nurses can be too?

Hierarchy itself is the problem, as you so eloquently note in your post. Mortality is a great leveler, with time mortality's gatekeeper.

Yet nurses, teachers, anyone who forms a union, immigrants demeaned with the term "illegal" on top of paltry wages and no legal protections in their workplace, making them ripe victims for abuse--are now routinely vilified by politicians and the media so that the top 2% of lawless international corporate heads who buy governments like cowboys used to shoot up saloons can have more and keep abusing.

Humanity can only make progress to the extent we stop allowing this insane pecking order to continue, and stop gougeing each others' eyes out, and instead, unite in an overwhelming tide of peace, as people are still ardently attempting to do in the Middle-East. All the people sitting and praying in church, isn't this what they are praying for?

About Me

My medical practice consists exclusively of listening to patients and their families. Having limited my focus since the late 1970s to cancer support group facilitation, I founded the support programs at Sutter Cancer Center in Sacramento and Sierra Nevada Cancer Center in Grass Valley, CA.
I’ve published dozens of periodical articles on the healing relationship. My most recent book is How to Heal: A Guide for Caregivers (Helios Press, 2003). I teach medical practitioners “bedside manner” in workshops nationally.